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Comparison of MIS vs. open PLIF/TLIF with regard to clinical improvement, fusion rate, and incidence of major complication: a meta-analysis

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Abstract

Purpose

Meta-analysis was conducted to estimate whether MiTLIF could reduce the complication rate while maintaining the similar clinical result to that of open procedures.

Methods

A search of the literature was conducted on pubmed or EMBASE. A database including patient clinical information was created. A systematic review of eligible studies with multivariate regression analysis was performed to quantitatively review the correlation of VAS improvement rate and the performance of MiTLIF.

Results

Fourteen articles with a minimum of 12-month follow-up met our inclusion criteria. The hypothesis of homogeneity could be accepted. The fixed-effects model was used to calculate the summary risk ratio (odds ratio). In the pooled analysis, the summary risk ratio (odds ratio) in patients with MiTLIF against those with open procedure for fusion rate, complication rate and revision/readmission rate was 0.99 (p = 0.36), 1.15 (p = 0.5) and 2.59 (p = 0.003), respectively, suggesting that MiTLIF was a risk factor for revision/readmission. Multivariate regression analysis showed that the percentage of male patients and the length of surgery exert a significant impact on VAS improvement rate. The selection of MiTLF was not significant.

Conclusion

Fusion rate and complication rate for both open and MiTLIF were similar. Moreover, the MiTLIF group tended to have a higher revision/readmission rate, which might be associated with the deep learning curve. Therefore, to achieve the level of surgical skill required of an MiTLIF surgeon, many years of training and experience are necessary. Otherwise, MiTLIF may yield unsatisfactory result upon patients.

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References

  1. Kalanithi PS, Patil CG, Boakye M (2009) National complication rates and disposition after posterior lumbar fusion for acquired spondylolisthesis. Spine (Phila Pa 1976) 34(18):1963–1969

    Article  Google Scholar 

  2. Tsutsumimoto T, Shimogata M, Ohta H, Misawa H (2009) Mini-open versus conventional open posterior lumbar interbody fusion for the treatment of lumbar degenerative spondylolisthesis: comparison of paraspinal muscle damage and slip reduction. Spine (Phila Pa 1976) 34(18):1923–1928

    Article  Google Scholar 

  3. Rodriguez-Vela J, Lobo-Escolar A, Joven E, Munoz-Marin J, Herrera A, Velilla J (2013) Clinical outcomes of minimally invasive versus open approach for one-level transforaminal lumbar interbody fusion at the 3- to 4-year follow-up. Eur Spine J 22(12):2857–2863

    Article  PubMed Central  PubMed  Google Scholar 

  4. Adogwa O, Parker SL, Bydon A, Cheng J, McGirt MJ (2011) Comparative effectiveness of minimally invasive versus open transforaminal lumbar interbody fusion: 2-year assessment of narcotic use, return to work, disability, and quality of life. J Spinal Disord Tech 24(8):479–484

    PubMed  Google Scholar 

  5. Schizas C, Tzinieris N, Tsiridis E, Kosmopoulos V (2009) Minimally invasive versus open transforaminal lumbar interbody fusion: evaluating initial experience. Int Orthop 33(6):1683–1688

    Article  PubMed Central  PubMed  Google Scholar 

  6. Peng CW, Yue WM, Poh SY, Yeo W, Tan SB (2009) Clinical and radiological outcomes of minimally invasive versus open transforaminal lumbar interbody fusion. Spine (Phila Pa 1976) 34(13):1385–1389

    Article  Google Scholar 

  7. Wang J, Zhou Y, Zhang ZF, Li CQ, Zheng WJ, Liu J (2010) Comparison of one-level minimally invasive and open transforaminal lumbar interbody fusion in degenerative and isthmic spondylolisthesis grades 1 and 2. Eur Spine J 19(10):1780–1784

    Article  PubMed Central  PubMed  Google Scholar 

  8. Shunwu F, Xing Z, Fengdong Z, Xiangqian F (2010) Minimally invasive transforaminal lumbar interbody fusion for the treatment of degenerative lumbar diseases. Spine (Phila Pa 1976) 35(17):1615–1620

    Article  Google Scholar 

  9. Adogwa O, Parker SL, Bydon A, Cheng J, McGirt MJ (2011) Comparative effectiveness of minimally invasive versus open transforaminal lumbar interbody fusion: 2-year assessment of narcotic use, return to work, disability, and quality of life. J Spinal Disord Tech

  10. Lau D, Lee JG, Han SJ, Lu DC, Chou D (2011) Complications and perioperative factors associated with learning the technique of minimally invasive transforaminal lumbar interbody fusion (TLIF). J Clin Neurosci 18(5):624–627

    Article  PubMed  Google Scholar 

  11. Park Y, Ha JW (2007) Comparison of one-level posterior lumbar interbody fusion performed with a minimally invasive approach or a traditional open approach. Spine (Phila Pa 1976) 32(5):537–543

    Article  Google Scholar 

  12. Kotani Y, Abumi K, Ito M, Sudo H, Abe Y, Minami A (2011) Mid-term clinical results of minimally invasive decompression and posterolateral fusion with percutaneous pedicle screws versus conventional approach for degenerative spondylolisthesis with spinal stenosis. Eur Spine J

  13. Kim DY, Lee SH, Chung SK, Lee HY (2005) Comparison of multifidus muscle atrophy and trunk extension muscle strength: percutaneous versus open pedicle screw fixation. Spine (Phila Pa 1976) 30(1):123–129

    Article  Google Scholar 

  14. Zairi F, Arikat A, Allaoui M, Assaker R (2013) Transforaminal lumbar interbody fusion: comparison between open and mini-open approaches with two years follow-up. J Neurol Surg A Cent Eur Neurosurg 74(3):131–135

    Article  CAS  PubMed  Google Scholar 

  15. Harris EB, Sayadipour A, Massey P, Duplantier NL, Anderson DG (2011) Mini-open versus open decompression and fusion for lumbar degenerative spondylolisthesis with stenosis. Am J Orthop (Belle Mead NJ) 40(12):E257–E261

    Google Scholar 

  16. Lee KH, Yue WM, Yeo W, Soeharno H, Tan SB (2012) Clinical and radiological outcomes of open versus minimally invasive transforaminal lumbar interbody fusion. Eur Spine J 21(11):2265–2270

    Article  PubMed Central  PubMed  Google Scholar 

  17. Villavicencio AT, Burneikiene S, Roeca CM, Nelson EL, Mason A (2010) Minimally invasive versus open transforaminal lumbar interbody fusion. Surg Neurol Int 1(12)

  18. Stang A (2010) Critical evaluation of the Newcastle–Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol 25(9):603–605

    Article  PubMed  Google Scholar 

  19. Zdeblick TA (1998) Laparoscopic spinal fusion. Orthop Clin North Am 29(4):635–645

    Article  CAS  PubMed  Google Scholar 

  20. Sihvonen T, Herno A, Paljarvi L, Airaksinen O, Partanen J, Tapaninaho A (1993) Local denervation atrophy of paraspinal muscles in postoperative failed back syndrome. Spine (Phila Pa 1976) 18(5):575–581

    Article  CAS  Google Scholar 

  21. McKinstry CS, Bell KE (1990) The failed back syndrome: the diagnostic contribution of computed tomography. Ulster Med J 59(2):122–130

    PubMed Central  CAS  PubMed  Google Scholar 

  22. Harrop JS, Youssef JA, Maltenfort M, Vorwald P et al (2008) Lumbar adjacent segment degeneration and disease after arthrodesis and total disc arthroplasty. Spine (Phila Pa 1976) 33(15):1701–1707

    Article  Google Scholar 

  23. Goldstein CL, Macwan K, Sundararajan K, Rampersaud YR (2014) Comparative outcomes of minimally invasive surgery for posterior lumbar fusion: a systematic review. Clin Orthop Relat Res 472(6):1727–1737

    Article  PubMed  Google Scholar 

  24. Kim SS, Denis F, Lonstein JE, Winter RB (1990) Factors affecting fusion rate in adult spondylolisthesis. Spine (Phila Pa 1976) 15(9):979–984

    Article  CAS  Google Scholar 

  25. Wu RH, Fraser JF, Hartl R (2010) Minimal access versus open transforaminal lumbar interbody fusion: meta-analysis of fusion rates. Spine (Phila Pa 1976) 35(26):2273–2281

    Article  Google Scholar 

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Author notes

    Authors and Affiliations

    1. Department of Orthopedics, NO.44 hospital, 64# Huanghe RD, Guiyang, 550009, Guizhou, China

      Qu Jin-tao, Shi Guo-hua, Chen Lei, Hu Yue & Wang Zi-tian

    2. Department of Orthopaedic, Affiliated Xinqiao Hospital, The Third Military Medical University, No. 2, Xinqiao St, Shapingba District, Chongqing, 400037, China

      Tang Yu & Zhou Yue

    3. NO.44 hospital, 64# Huanghe RD, Guiyang, 550009, Guizhou, China

      Wang Mei, Tang Xu-dong & Zhang Tian-jian

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    1. Qu Jin-tao
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    Corresponding authors

    Correspondence to Hu Yue or Zhou Yue.

    Additional information

    Q. Jin-tao and T. Yu contributed equally to this work.

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    Jin-tao, Q., Yu, T., Mei, W. et al. Comparison of MIS vs. open PLIF/TLIF with regard to clinical improvement, fusion rate, and incidence of major complication: a meta-analysis. Eur Spine J 24, 1058–1065 (2015). https://doi.org/10.1007/s00586-015-3890-5

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    • DOI: https://doi.org/10.1007/s00586-015-3890-5

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